Friday, October 4, 2013

Pictures include- slight confusion with finding our connecting flight in Qatar, the protocol officers waiting for us in Dhaka, the rickshaws lined up on our streets, the copious amounts (40lbs) of hibiclens we brought ot supply the hospital (with my cheez-it stash of course), teaching in the classroom and on the Oncology ward with my colleague Meg Garvey and our students, the full medical list at DMCH, (un)safe public transportation in Dhaka and my extremely sweaty back after a long day in the 98 degree weather without A/C

Thursday, October 3, 2013

After an abrupt departure from Bangladesh in May due to
concern for safetyamongst the growing
political riots and heightened tension, I have returned back to the “desh” for 10
days with additional Mass General staff to assist in the continued education
and guidance of the nurses who will be working on the new Bone Marrow
Transplant unit. It’s been 5 months away, but, with my old Bangla friends and DMCH nurses back at my side, part of me forgets
that Maryanne and I ever left at all.

The Bone Marrow Transplant (BMT) is scheduled to open on the 23rd of
this month, and while the diligent volunteers from MGH (on the ground, and back
in Boston) seem to be fixing a problem at every turn, four new challenges seem
to appear in its place. Because BMT is one most complicated oncology procedures
performed due to the isolation, precautions and strict scheduling required for
a patient to thrive, it feels like a bold contradiction to build one in
Bangladesh, a country lacking in such basic medical resources. I told one
colleague today that every time I think about the work to be done, I am left
with a head filled with doubt but a heart full of hope.

Everybody keeps asking how it feels to be back in Bangladesh
on a personal level and it hasn’t been an answer I could sum up in a few
sentences, so for those of you who want to know my honest answers enough to
read my blog, here are my extended thoughts
to the Yes’s and No’s, I so routinely deliver to your questions.

Are you scared? To this I have thought,
only that we won’t get the work done, and that I will be the only person in the
history of global health who ever gained weight in a third world country from
the copious carb diet.

What are you thinking,
going back to a place you got evacuated from, have you not learned your lesson?To this I usually giggle and assure you I have thought it through but really
want to tell you that “every lesson I have every learned enough to carry to the
present has been built on the grounds of perseverance, finding a window when
the door shuts, never giving up and putting human life above all other worth,
so no I guess I haven’t learned whatever lesson you are referring to”. For the
record, if you’ve asked me that question, I still love you more than words can
say and that I know you have my best interests at heart.

Is it worthwhile to endure
a 24 hour trip each way for only ten days on the ground? I answered a
hesitant yes last night, but I knew I answered correctly at the end of the
hospital shift today. My colleague Meg (who has been a BMT RN at MGH for 20
years) and I returned back to the classroom after being on the floor for
clinical practice, and I was hot, exhausted and really, really sweaty (pictures
to follow) but then I looked at these nurses who are so excited to advance
their education despite lack of pay raise or benefits but just because they
love nursing and so my answer may be a tired, exhausted and sweaty yes, but nonetheless, always a yes.

Friday, May 10, 2013

The Nursing Bridge Program asked Maryanne and I to write an article on what International Nursing Day means to us. Below is what we came up with. Enjoy!...

Every year on nurses day, we as nurses, take time to reflect on how proud we are to have chosen the nursing field. We reflect on the incredible importance nursing is as a profession. In the United States, nursing routinely tops the Gallop poll of "Most Trusted Profession" with 85% of Americans rating the ethical and honesty standards of a nurses at "very high/ high". These standards continue to amaze us. It's such a unique profession with so many different roles which has a universal acknowledgement for being so "noble."

We have spent countless hours listening to our friends and pondering their stories of nursing across the spectrum. We heard the stories of a neonatal ICU nurse after she described the experiences of helping a mother rock her dying baby for the last time. We have beamed with pride as a friend told us the signs and symptoms she recognized when her patient was having a heart attack, and assisted in getting him immediate and lifesaving treatment. It's not an uncommon site to see a coworker braid a patients hair and massage her hands through a chemotherapy infusion despite her heavy workload because she wanted to calm the patent's nerves. And most recently, we fought back tears as we walked around a crowded unit at Dhaka Medical College Hospital and witnessed the nurses comfort the victims from the recent factory collapse in Savar.

Nursing continues to be a profession that while growing and changing, remains to be a necessity for improved outcomes in patient safety. We were chosen by Massachusetts General Hospital through a Global Health Care fellowship to promote, encourage and educate nursing with the eventual goal of opening a Bone Marrow Transplant Unit. While coming here with the primary goal of teaching, we find ourselves learning from the nurses just as much as we hope they learn from us.

At a recent class at Dhaka Medical College we asked the nurses what drew them into the nursing profession. Each and every single nurse told us through their native language, "I chose to be a nurse because it is the work of the heart". Fortunately, it was a sentence we could understand without the use of an interpreter.

That evening while discussing our newest lesson plans, we discussed how well we were adapting to our roles in Bangladesh. We may have been brought into Dhaka through the nursing AK Khan Healthcare Trust to assist in advancing the nursing medical expertise and instructing clinical skill set, but every student in our classroom already had the nursing "heart", which is the only requirement of the profession that cannot be taught

Friday, May 3, 2013

As many of you may already know, last night I had the pleasure of being interviewed by CNN’s Moni Basu. This was an incredible honor, not only because Moni is an astonishing writer (no seriously, check out her personal blog - http://evilreporterchick.com/, her stories are unlike anything I’ve ever read), but she made me feel incredibly safe and comfortable during the interview AND grew up in India but is Bangladeshi by birth!!! How cool?

While I initially submitted the story from my blog (errr….or was forced by Riley Fadden), my hope was that I could have a few Americans wake up to the horrors in South East Asia. Horrors, that I, myself had not known existed until I moved to Dhaka. I would never have imagined that the story would become a cover feature on CNN, although to be honest, I would still have preferred to live in a world where no such story existed.

Someone said to me when I was trying to process explaining the scene of meeting the victims “Laura, you can’t save this, stop stressing yourself out”. I know that, but I am glad the majority of people were on my side saying “You might not be able to save it, but you don’t have to stop trying to get people to listen”. I am an incredibly lucky girl to have these cheerleaders just a skype, imessage, whatsapp and face time away.

The article may have made me look like a hero, but the real credit goes to the masterminds that took an improbable idea, and have us here, working to turn the dream into the reality of Bangladesh’s first Bone Marrow Transplant Center:

Dr. Bimal Dey, who was born in Bangladesh and is now an incredible Oncologist and asset to MGH. Being one of the most intelligent MD’s I have encountered he is also the most down to earth, has an INCREDIBLE respect for nursing, and is always just a phone call away when we need him.

Anne-Marie Barron who was my favorite professor at Simmons College and who has been my biggest mentor at MGH. She is an incredible, kind and intelligent person who has spent much time in Bangladesh to open a nursing school and help promote nursing. She is also an incredibly calming presence, even just on skype.

The AK Khan Trust and family, the Nursing Bridge Program, the honorable Health Minister of Bangladesh, The oncologist/hematologist at DMC ( especially Dr. Khan), and supports back at Massachusetts General Hospital including Jason Harlow and Mark Breznia, NP who have all supported us so much, continue to listen to our thoughts and are working tirelessly to see the first BMT center through. A thousand thanks to you all.

Maryanne Meadows, my partner in crime and savior in this new and different world. We made a pact to laugh at the end of the day and she has made me keep that promise even on the hardest of days here. Her incredible blog gives much more insight to our journey, check it out- http://maryannemeadows.blogspot.com/

And most importantly, to the Nurses and people of Bangladesh, I hope the world never forgets about your incredible resilience in the face of a tragedy that is so horrific, I continue to be at a loss of words. You will forever be tattooed on my heart and I promise to never stop telling your story to anyone who will listen.

Sunday, April 28, 2013

Photos includes: My new fitted pants, lecturing in the classroom, instructing on the medical ward, meeting with the directors of DMCH Oncology and the nursing bridge trust, the sunset from my deck, the sunrise from my roof, a riveting ride on a rickshaw, my bedtime bug protection, and the escalating riots.

When I was 17 my least favorite morning of the week was
Saturday.With an ever-changing extracurricular
activity schedule, Saturday morning was my one set shift at the local dry
cleaners, which dragged me out of bed before 8am, and at that age indicated
torture. The shift lasted four hours and always included a bagel brought by a
sympathetic friend and a pile of gossip magazines supplied by my boss to
entertain me while in-between helping customers at the counter. I should also
mention that I received $40 for those “hard” worked Saturdays, totaling $120.00
a month pre-taxes.

On Wednesday, any avid news watcher would be able to tell
you that a factory building collapsed in Dhaka, Bangladesh which housed 3,122
employees who produced garmentsthat are
out sourced for the western world. And by this morning, any avid news watcher
could tell you that the death toll count of these factory workers is up to 364,
with 2,200 rescued (many at the cost of their limbs), and an estimated 550
people missing under the debris. With today marking Sunday, the 5th
day since the catastrophe, it is well past the estimated 72 hours a human being
can survive without food and water. I mentioned those who would know these
facts would have to be an avid news watcher because it has been my observation
that these stories, even in Dhaka, run second and third to what is happening in
the first or Western World. On Thursday I could tell you more about how much
the Boston Marathon bombers mother shoplifted from a Natick, MA mall then how
many factory workers were still missing from watching the news.

I was reminded of my job at the local dry cleaners and my
$120.00 a month I then received, as I watched a 17 year old girl interviewed
today after her hand was cut off from the slab of cement it was mangled under to
rescue her from debris. The station called her lucky and I went numb thinking
how at age 17 I would have defined lucky. It would have incorporated more than
a minimum wage of $38.00 a month, it would have indicated that if a building
was deemed unsafe on a Tuesday, I would not have been forced to return on a
Wednesday, and without question it would have included 2 hands.

Being American I know that I am just as much part of the
problem as the solution. As I walked the hospital corridors down to the ward
filled with women rescued from the collapse today, I realized any of the items
I was clothed in may have come from a similar unsafe factory in Asia, as
Bangladesh reports they release 23% of their garment productions to America
annually. I realized while I was being brought down to comfort them, I just as
much owed them an apology for being part of a world that allows this kind of treatment
and I caught my breathe when my guide was asked to bring us to the unit at another
time as the Prime Minister of Bangladesh
was currently inside visiting.

As we turned to leave someone asked me, “If you want I can
take you outside to see the piles of bodies that weren’t pronounced dead until
they got to the hospital”, and while I politely declined, I turned in time to
see a lifeless woman my age being wheeled by to join the others. I said a
prayer, not knowing if it was to the god she believed in or the one I had been
raised to believe in, but pictured both fundamentallysaying “We hate this too, were working on it,
and so can you”.

Tuesday, April 23, 2013

Each day I have spent at Dhaka Medical College Hospital has
ended the same. After finishing our meetings, Maryanne and I are accompanied
outside by members of the trust and I pretend to not notice the vastly growing
crowd that surrounds our small group. Our driverpulls up and we are shuffled into a van while
people either bang at the windows or take our picture and we are whiskedoff into the sunset. I know how it sounds.It sounds romantic and glamorous, like, say,
a celebrities blog which accounts her stressful day as she tries to shop
alone.But it is neither romantic nor
glamorous.The people who surround the
car are not paparazzi, in fact they are living on less than a dollar a day
according to water.org and are suffering from a variety of ailments, some of
which don’t even exist in the western world. And they bang on the windows
because they think the two, western girls inside the comfortable,
air-conditionedvan, have the answers on
how to either feed or cure them or maybe even both.

Dhaka Medical College Hospital (DMCH) is meant to be a 1,700 bed hospital. I say
meant because it is government run, meaning it is free to those who can’t
afford payment and it turns no one away. According to the hospital’s director,
a daily census may run anywhere from 2,500 to 4,000 patients and due to the
overflowing population in the building, every turn of the head shows patients
sharing beds, lying on the floor or sitting in stairwells mid- treatment. While
patients lying in stairwells defies fall prevention protocol at every turn,
contact precautions are non-existentand
the roles of physical, respiratory , speech and occupational therapist all
falls onto the doctor or nurse, amazingly, DMCH still manages to get patients better.

The nurse’s role at the hospital is quite different from
what I am used to, which is what we were brought into assist with via lecture
and one-on-one clinical training. As one DMCH attending physician explained to
me “Your skill set would make you a doctor here, the nurses here act more like
maids.” And with one nurse to a ward that averages 25-30 patients, no skilled
assistance and orders written in English instead of their native Bangla
language, I am concerned with the lack of room for improvement. However, despite
their heavy workload and lack of break (the nurses work up until lecture time
and then get someone to cover their ward for 2-3 hours to hear us present, I am
beyond amazed at their rising English skills, perseverance and optimism as they
come to lecture not only motivated but excited to be selected and trained for
the end result, Bangladesh’s first Bone Marrow Transplant unit.

Each day I ride home with DMCH and its many faces of
illness, despair, need and hope in my thoughts long after the vast white
building is out of sight. And while I spend the ride wishing I had the key to
fix the suffering of the Bengali people, I know I do not, I could not. So, I repeat a favorite Florence Nightingale
quote of mine “never lose an
opportunity of urging a practical beginning, however small, for it is wonderful
how often in such matters the mustard-seed germinates and roots itself “, and I
hope the small group of nurses suffice.